Members of the Toxic Pfiesteria Complex (TPC) include Pfiesteria piscicida and Pfiesteria shumwayae.
The CDC criteria for the possible-estuary associated syndrome:
(1) The patient develops symptoms within 2 weeks after exposure to estuarine waters.
(2) The patient develops:
(2a) memory loss or confusion of any duration, OR
(2b) 3 or more of the following symptoms for >= 2 weeks: burning skin, eye irritation, upper respiratory irritation, muscle cramps, and gastrointestinal symptoms.
(3) A health care provider cannot identify another cause for the symptoms.
where:
• Exposure may consist of (a) swimming or other skin contact with water, (b) drinking contaminated water, (c) exposure to affected fish, or (d) inhalation of aerosolized or volatilized toxins.
• The onset of acute illness may be 24-36 hours after the exposure.
• A skin rash may develop at the site of skin contact with water.
• The sensation of burning skin may be noted shortly after touching the water. It may not persist for >= 2 weeks.
• Gastrointestinal symptoms include secretory diarrhea, abdominal pain and anorexia.
• Patients may also note: weight loss, sensitivity to bright lights, fatigue, muscle aches, lethargy, vertigo, shortness of breath and cough.
• The patient may have noted a large number of diseased, dying or dead fish.
• Untreated the disorder may become chronic and last for 6 or more months.
• A patient treated for PEAS syndrome may have symptoms resolve before 2 weeks have passed.
Demonstration of a sharp reduction in visual contrast sensitivity (VCS) provides an objective finding for PEAS. This measures the patient's ability to detect visual patterns.
Standard treatment protocol for PEAS:
(1) cholestyramine
(2) sorbitol, 70% solution
(3) Prilosec
